Early Screening of Chronic Post-sternotomy Pain Using the DN4-i Questionnaire

Association Between Early Neuropathic Pain and Chronic Post-Sternotomy Pain After Coronary Artery Bypass Grafting (CABG): A Prospective Observational Study

Chronic post-sternotomy pain (CPSP) is a common complication after cardiac surgery, with a reported prevalence between 30% and 50%. Several studies show that a significant proportion of patients experience persistent pain long after cardiac surgery, often with a neuropathic component. Internal mammary artery harvesting is known to cause intercostal nerve injury. Recent data suggest that early neuropathic pain, assessed using the DN4 score, may predict the chronicization of postoperative pain.

This study is a prospective observationnal study to evaluate the association between early neuropathic pain (DN4-i ≥ 3/7 on postoperative day 5) and the occurrence of chronic post-sternotomy pain at 3 months in patients who underwent median sternotomy for coronary artery bypass grafting with internal mammary artery harvesting

Inclusion Criteria:

• Age ≥ 18 years
• Scheduled cardiac surgery with coronary artery bypass via median sternotomy with internal mammary artery harvesting
• Patients receive an information sheet and a non-opposition form.

Exclusion Criteria:

• History of sternotomy
• Early reoperation < 30 days
• Chronic treatment with strong opioids or neuropahtic pain medications
• Severe cognitive impairment
• Patients under legal protection or guardianship